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Med Surg 2 > Leukemia > Flashcards

Leukemia Flashcards

1
Q

What is leukemia?

A

Blood cancer that results from a loss of normal cellular regulation leading to uncontrolled production of immature WBCs in bone marrow

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2
Q

What can leukemia progress to?

A

myelodyplastic syndromes (MDs) = all patients have a decrease in all circulating blood cell types

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3
Q

What does leukemia lead to?

A

Anemia, thrombocytopenia, leukopenia

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4
Q

How is leukemia classified?

A

By cell types
-lymphocytic
-myelocytic
-biphenotypic leukemia (both types combined)

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5
Q

What is acute leukemia?

A

Sudden onset, rapid growing, more severe symptoms, bone marrow produces immature WBCs
-needs immeidate tx

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6
Q

What is chronic leukemia?

A

Slow onset, persists for months to years
-slow growing, usually milder symptoms
-bone marrow produces more mature cells (not fully developed)
-may not require immediate tx

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7
Q

What puts someone at risk for leukemia?

A

radiation, viral infection, exposure to chemicals & drugs, genetic factors, immunity factors

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8
Q

What assessment history do you need to gather?

A

RF
genetic factors
age
occupation
hobbies
medical hx- medications & radiations
infections
bleeding issues
weakness
fatigue

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9
Q

What does leukemia affect?

A

All organs and systems

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10
Q

How does it impact the CV system?

A

tachycardia
HYPOtension
slow capillary refill
murmurs
bruits
**HYPO and tachy due to anemia since the blood is thin so not a lot of O2 = decreased perfusion

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11
Q

What happens when WBC is high?

A

blood is THICCCK = HYPERtension with bounding pulses

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12
Q

How does it impact the respiratory system?

A

tachypnea
infiltrates
respiratory infection

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13
Q

What are the signs of respiratory infection?

A

cough
dyspnea
abnormal breath sounds

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14
Q

How does it impact the integumentary system?

A

pallor
cool
petechiae
poor healing wounds
bleeding gums

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15
Q

How does it impact the GI/GU system?

A

weight loss
nausea
anorexia
rectal & GI bleeding
decreased bowel sounds
liver enlargement
spleen enlargement
aBdominal pain/tenderness
hematuria

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16
Q

How does it impact the CNS?

A

cranial nerve changes
headache
seizure
papilledema
coma
fatigue
fever
behavior changes
somnolence
reduced attention

17
Q

How does it impact the MS?

A

bone pain
joint swelling & pain
muscle weakness

18
Q

What types of patients have a poorer prognosis?

A

Patients with a high immature WBC count at diagnosis

19
Q

Whats another sign of leukemia?

A

lymph node enlargement

20
Q

How do the labs appear?

A

Hemoglobin & hematocrit = low
platelet count = low
WBC= low, normal or high
reduced level of clotting factor
aPTT = prolonged
thrombocytopenia

21
Q

Normal hematocrit

A
22
Q

Normal hemoglobin

A
23
Q

Normal platelet count

A
24
Q

Normal WBCs

A
25
Q

How to diagnosis leukemia?

A

bone marrow aspiration & biopsy
chromosome analysis (cytogenic studies)
imaging- x-ray/ bone density

26
Q

Interventions for infection

A

infection prevention
drug therapy for infection
antibiotic prophylaxis
pulmonary hygiene
specialized unit
handwashing
aesptic technique
skin care
ensure those who enter the room are not sick
neutropenic precautions

27
Q

What needs to be assessed to make sure no infection and sepsis?

A

-CBC with diff - WBC, Absolute neutrophils
-respiratory assessment
-assess urination & urine
-VS with temp

28
Q

What are the 3 distinct phases of drug therapy for acute leukemia?

A

induction, consolidation, maintenance

29
Q

What happens during induction?

A

combo chemo- 7 plus 3

30
Q

What are the complications that can occur during induction?

A

infection, kidney/liver/cardiac toxicity, NVD, stomatitis, alopecia

31
Q

What is more common during the induction phase?

A

infection related deaths

32
Q

What happens during the consolidation phase?

A

another round of chemo
-occurs only in remission

33
Q

What happens during the maintenance phase?

A

months to years after induction & consolidation

34
Q

What is first line drug therapy for chronic leukemia?

A

Imatiruib mesylate (Gleevac)

Med Surg 2 (10 decks)

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